How does it work?

Dextromethorphan is a type of medicine called a cough suppressant. It is used to suppress a dry, tickly, unproductive cough.

Coughing is a reflex response to irritation of the airways. It is useful for clearing mucus, dust and other particles from the throat and lungs. It is important because it reduces the amount of mucus, dust and bacteria in the airways that would otherwise make breathing difficult. However, sometimes coughing can become overstimulated even when there is no mucus to clear from the lungs or throat. In this situation coughing serves no purpose and can become painful and frustrating.

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Dextromethorphan is used to block the cough reflex in situations where the cough serves no purpose, ie when no plegm is being coughed up. It works by reducing the nerve signals sent from a part of the brain called the coughing centre to the muscles that produce coughing.

Doxylamine is a type of medicine called a sedating antihistamine. It enters the brain in sufficient quantities to cause drowsiness. When taken at bedtime it can help give a restful nights sleep. Its sedative effect may also help suppress a cough.

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Nasal mucus can often be the cause of cough in a cold, because it drips down the back of the throat, causing irritation. Doxylamine also drys nasal secretions, by stopping a natural body chemical called histamine from binding to its receptors. Histamine is a chemical produced naturally by the body that has many effects, including the production of allergic symptoms, such as a runny nose. Blocking histamine receptors prevents the actions of histamine, which reduces the production of mucus in the nose.

Pseudoephedrine is a type of medicine called a decongestant. It works by acting on alpha receptors that are found in the walls of blood vessels in the linings of the nasal passages and sinuses. It causes these blood vessels to contract and narrow, thereby decreasing blood flow into the linings of the nose and sinuses. This reduces the feeling of congestion and also reduces the production of mucus.

Pseudoephedrine also has a weak effect on receptors in the lungs called beta 2 receptors. By acting on these receptors it causes the muscles in the airways to relax. This allows the airways to open, making breathing easier.

Paracetamol is a simple painkilling medicine used to relieve mild to moderate pain and fever. Despite its widespread use for over 100 years, we still don't fully understand how paracetamol works to relieve pain and reduce fever. However, it is now thought that it works by reducing the production of prostaglandins in the brain and spinal cord.

The body produces prostaglandins in response to injury and certain diseases. One of the effects of prostaglandins is to sensitise nerve endings, causing pain (presumably to prevent us from causing further harm to the area). As paracetamol reduces the production of these nerve sensitising prostaglandins it is thought it may increase our pain threshold, so that although the cause of the pain remains, we can feel it less.

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It is thought paracetamol reduces fever by affecting an area of the brain that regulates our body temperature (the hypothalamic heat-regulating center).

The combination of active ingredients in Vicks cold & flu care medinite complete helps to relieve the symptoms of colds and flu, such as aches and pains, fever, runny nose, nasal congestion, sore throat and cough, and can help you get a good nights sleep.

How do I take it?

Adults and children over 12 years of age should take one 30ml dose from the measuring cup supplied at bedtime.

Warning!

This medicine may cause drowsiness. If affected do not drive or operate machinery. Alcohol should be avoided.

Do not take this medicine with any other products that contain paracetamol. Many over-the-counter painkillers and cold and flu remedies contain paracetamol. It is important to check the ingredients of any medicines you buy without a prescription before taking them in combination with this medicine. Seek further advice from your pharmacist.

An overdose of paracetamol is dangerous and capable of causing serious damage to the liver and kidneys. You should never exceed the dose stated in the information leaflet supplied with this medicine. Immediate medical advice should be sought in the event of an overdose with this medicine, even if you feel well, because of the risk of delayed, serious liver damage.

Alcohol increases the risk of liver damage that can occur if an overdose of paracetamol is taken. The hazards of paracetamol overdose are greater in persistant heavy drinkers and in people with alcoholic liver disease.

If you have any of the following symptoms you should not take this medicine and consult your doctor so that your cough can be investigated further: coughing up phlegm that is green, rusty brown, yellow, blood-stained or foul smelling; shortness of breath, wheezing or difficulty breathing; chest pain; pain and swelling in the calf; sudden weight loss; recurrent night-time cough; or a long-term persistent cough.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Use with caution in

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Although paracetamol is generally considered safe to take during pregnancy, the safety of dextromethorphan, doxylamine and pseudoephedrine for use during pregnancy has not been established. Some studies have suggested that use of pseudoephedrine in the first trimester may be associated with defective closure of the abdominal wall (gastroschisis) in the baby. As a result, this medicine is not usually recommended for use by women who are pregnant. Seek further medical advice from your doctor, pharmacist or midwife.

Although paracetamol is generally considered safe to take during breastfeeding, it is not known if dextromethorphan passes into breast milk. Small amounts of pseudoephedrine pass into breast milk. The amount is probably too small to be harmful to a nursing infant. However, when taken by mouth, decongestants such as pseudoephedrine can temporarily decrease the production of breast milk with just one or two doses. For these reasons, this medicine is best avoided by mothers who are breastfeeding. Ask your doctor or pharmacist for further advice

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Drowsiness.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.

Dizziness.

Restlessness.

Difficulty sleeping (insomnia).

Anxiety.

Increased heart rate.

Rash.

Difficulty passing urine.

False perceptions of things that are not really there (hallucinations).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

If you are already taking any other medicines, including herbal medicines and those bought without a prescription, you should check with your pharmacist before using this medicine, to ensure that the combination is safe.

You should not use other cough, cold and flu or decongestant medicines in combination with this one. It's particularly important that you don't take other medicines that contain paracetamol in combination with this medicine, as this can easily result in exceeding the maximum recommended daily dose of paracetamol. Many cough, cold and flu remedies and over-the-counter painkillers contain paracetamol, so be sure to check the ingredients of other medicines before taking them with this one, or ask your pharmacist for advice.

You should not use this medicine if you are currently taking a type of medicine called a monoamine oxidase inhibitor (MAOI), or have taken one of these medicines in the last 14 days. MAOIs include the antidepressants phenelzine, tranylcypromine, isocarboxazid and moclobemide, and the anti-Parkinson's medicines selegiline and rasagiline. This is because the combination of pseudoephedrine with these medicines could cause a dangerous increase in blood pressure (hypertensive crisis).

If pseudoephedrine is taken with any of the following the combination may cause an increase in blood pressure. If you are already taking any of these medicines you should avoid taking this one as well:

other decongestants (often found in non-prescription cough and cold remedies)

the antibiotic linezolid

tricyclic antidepressants, eg amitriptyline.

Pseudoephedrine may reduce the effects of medicines to treat high blood pressure (antihypertensives). If you are taking medicines for high blood pressure you should not take this medicine unless on the advice of a doctor.

This medicine may cause drowsiness. If this occurs, it may be made worse if the medicine is taken in combination with any of the following, which can also cause drowsiness:

alcohol

benzodiazepines, eg temazepam, diazepam

sedating antihistamines, eg chlorphenamine, diphenhydramine, triprolidine (these are often found in other non-prescription cough and cold or hayfever remedies)

sleeping tablets, eg zopiclone

strong opioid painkillers, eg codeine, dihydrocodeine, morphine

tricyclic antidepressants, eg amitriptyline.

Cholestyramine reduces the absorption of paracetamol from the gut. It should not be taken within an hour of taking paracetamol or the effect of the paracetamol will be reduced.

Metoclopramide and domperidone may increase the absorption of paracetamol from the gut.

Long-term or regular use of paracetamol may increase the anti-blood-clotting effect of warfarin and other anticoagulant medicines, leading to an increased risk of bleeding. This effect does not occur with occasional pain-killing doses.

Other medicines containing the same active ingredients

There are currently no other medicines available in the UK that contain this combination of active ingredients.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.